For the health challenges facing developing countries, the numbers alone are staggering. Every day, 40,000 people - enough to fill a sports stadium - die from preventable infectious diseases and malnutrition. Entire generations of human potential are perishing.
Given the scope of these challenges, is there a way for developing countries to solve health disparities and bootstrap these efforts into economic growth? In an article published recently in the journal Science, Biodesign Institute researchers Rich Mahoney and Anatole Krattiger, along with a large, international group of collaborators, have outlined new strategies to help developing countries address neglected diseases.
"Many developing countries are attempting to solve the health problems facing their own populations, and they are rapidly increasing investments in science and technology infrastructure," said Mahoney.
In addition to their research roles in the institute's Center for Infectious Diseases and Vaccinology, Mahoney and Krattiger also serve as advisors to the Rockefeller Foundation. The Foundation asked Mahoney to help organize an international meeting to address how disadvantaged countries could better foster scientific and technology innovation to directly impact health issues. Conducted in Bellagio, Italy in April, the meeting led to development of the Science article.
Participants concluded that the best approach for developing countries may be to pool their resources through "health innovation networks." By working together, the poorest countries stand a better chance of fostering innovation and building economic strength.
The recommended approach sets a top priority of developing public-private partnerships to address these needs. The group suggests that harmonized development in each of six sectors is essential to success in developing innovation systems: manufacturing, domestic markets, export markets, research and development (R&D), intellectual property (IP) systems, and drug regulatory systems.
Mahoney and Krattiger have expertise in one of these crucial aspects: intellectual property (IP).
"Innovation has to include strong public-private collaboration with a clear understanding of the comparative advantages of each sector," said Mahoney. "The big question regarding IP is: How can the public sector better manage IP to help ensure affordable medicines for the poor in developing countries?"
One important component, they say, is improving the linkages between developing and developed countries. Recognizing that global health is critical from both a humanitarian and pragmatic standpoint, philanthropic and government agencies are stepping up to the plate, donating more than $1 billion by 2003 in global product develop partnerships (PDPs) for new drugs, vaccines and diagnostics for diseases of the poor.
Another promising sign is the success being realized by some countries, despite both their relatively low economic strength and per capita income when compared to the U.S., Japan and Europe. These "rising stars" are called innovative developing countries, or IDCs, where recent and rapid increases in R&D investments, longer-term investments in science and engineering education, and increased manufacturing capacity are leading to favorable trends in patents and research citations.
For example, thanks to major investments, China is now the leading manufacturer of penicillin and India, by volume, is now the fourth largest producer of pharmaceuticals in the world.
In fact, the pooled national health research assets of IDCs including Argentina, Brazil, Cuba, China, Indonesia, Malaysia, Mexico, South Africa and Thailand were a combined $2.3 billion in 1998 compared to the U.S. National Institutes of Health's $13.6 billion.
While this is a step in the right direction, Mahoney and Krattiger point out a major concern. Companies within IDCs are growing rapidly, but all are being driven to maximize a direct economic return of investment, rather than the specific health needs of their populations. As a result, the poor in these countries are not yet benefiting from the new science practiced in their own countries.
"We don't believe that economic development and addressing national health needs must be mutually exclusive," said Krattiger "There are tensions between the two, but the group concurred that the two are reconcilable."